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Illinois rates for HCPCS A9604

Sm 153 Lexidronam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,631.57 / $15,631.57 / $58,096.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,631.57 / $15,631.57 / $16,608.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,911.42 / $120,363.07 / $266,713.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $200.00 / $13,252.88
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $18,502.89